Abstract: Objective To analyze the predictive value of serum neuropeptide Y (NPY) level combined with SeLECTscore for post-stroke epilepsy (PSE) in patients with ischemic stroke. Methods A total of 258 patients with acute ischemic stroke admitted to our hospital from July 2018 to June 2020 were divided into PSE group(n=31) and non-PSE group(n=227) according to the definition of epilepsy by the International League Against Epilepsy.Serum NPY level was detected by enzyme-linked immunosorbent assay and SeLECT score was recorded. Results Serum NPY level in PSE group (108.31±33.44 ng/mL 76.47±21.45 ng/mL)and SeLECT score (5.13±2.37 vs.4.27±2.58) were significantly higher than those in non-PSE group (P＜0.001).After adjusting for multiple confounding factors,multivariate Logistic regression analysis showed that SeLECT score[odds ratio (HR):1.278,95% confidence interval (CI):1.108～1.475,P=0.003] and serum NPY (HR:1.047,95% CI:1.033～1.063,P＜0.001) at admission was an independent risk factor for PSE.According to the analysis of the receiver operating characteristic,the area under the curve of PSE occurs in IS patients predicted by serum NYP level combined SeLECT score was 0.844 (95%CI:0.798～0.889),which is better than the prediction of the two alone. Conclusion SeLECT score combined with serum NPY at admission may become a new prognostic tool for predicting PSE.

Key words: Neuropeptide Y, SeLECT score, Ischemic Stroke, Post-stroke epilepsy

摘要： 目的 分析血清神经肽Y(NPY)水平、SeLECT评分对缺血性脑卒中后癫痫发作(PSE)的预测价值。方法 选取2018年7月至2020年6月期间我院收治的258例急性缺血性脑卒中患者,根据国际抗癫痫联盟癫痫发作定义将患者分为PSE(n=31)组及非PSE组(n=227)。采用酶联免疫吸附试验法检测入院时血清NPY水平,根据Galovic等建立的评分系统,计算患者入院时SeLECT评分。结果 PSE组患者血清NPY水平(108.31±33.44 ng/mL 76.47±21.45 ng/mL)及SeLECT评分(5.13±2.37分 vs.4.27±2.58分)均显著高于非PSE组患者(P＜0.001)。经多因素Logistic回归分析,在校正多种混杂因素后,入院时SeLECT评分[比值比(HR):1.278,95%可信区间(CI):1.108～1.475,P=0.003]和血清NPY(HR:1.047,95%CI:1.033～1.063,P＜0.001)是PSE的独立危险因素。经受试者工作特征曲线分析,血清NYP水平、SeLECT评分联合预测IS患者发生PSE的曲线下面积分别为0.844(95%CI:0.798～0.889),优于二者单独预测。结论 入院时SeLECT评分联合血清NPY有可能成为预测PSE的一种新的预后工具。

关键词: 神经肽Y, SeLECT评分, 缺血性脑卒中, 卒中后癫痫